Observational studyClinical infectious diseases : an official publication of the Infectious Diseases Society of America2024
Targeting Tularemia: Clinical, Laboratory, and Treatment Outcomes From an 11-year Retrospective Observational Cohort in Northern Sweden.
Observational study in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 14 citations in OpenAlex.
- Aminoglycosides: Is there an effective alternative in severe tularaemia? A case series.Infection · 2026Article
- A single-center study of a waterborne tularemia outbreak among adults and children in Turkiye.BMC infectious diseases · 2026Article
- From Sequence to Solution: Computational Design of a Multi-Epitope Vaccine Candidate Against Francisella tularensis.Probiotics and antimicrobial proteins · 2026Article
- Clinical Characteristics and Treatment Strategies in a Cohort of Patients with Tularemia: A Retrospective Multicenter Analysis of 65 Cases in Germany.Antibiotics (Basel, Switzerland) · 2025Article
- Assessment of Brucellosis Seropositivity in Patients Diagnosed with Tularemia.Journal of clinical practice and research · 2025Article
- An Outbreak of Pulmonary Tularemia in Slovenia in Summer 2024.Epidemiologia (Basel, Switzerland) · 2025Article
- Prosthetic joint infection as an unusual presentation ofIDCases · 2025Article
- An Emerging Role for Ticks as Vectors of Tularaemia in Sweden.Veterinary medicine and science · 2025Article
- Non-vaccinal prophylaxis of tularemia.Frontiers in microbiology · 2024Review
Corrections and comments
- Erratum issued
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundTularemia is an important reemerging disease with a multimodal transmission pattern. Treatment outcomes of current recommended antibiotic regimens (including ciprofloxacin and doxycycline) remain unclear. In this retrospective cohort study, we report clinical, laboratory, geographical, and treatment outcomes of laboratory-confirmed tularemia cases over an 11-year period in Northern Sweden.
methodsData from reported tularemia cases (aged >10 years at time of study) in Norrbotten county between 2011 and 2021 were collected through review of electronic medical records and participant questionnaires; 415 of 784 accepted participation (52.9%). Of these, 327 were laboratory-confirmed cases (serology and/or polymerase chain reaction). A multivariable logistic regression model was used to investigate variables associated with retreatment.
resultsMedian age of participants was 54 years (interquartile range [IQR], 41.5-65) and 49.2% were female. Although ulceroglandular tularemia was the predominant form (n = 215, 65.7%), there were several cases of pulmonary tularemia (n = 40; 12.2%). Inflammatory markers were largely nonspecific, with monocytosis frequently observed (n = 36/75; 48%). Tularemia was often misdiagnosed on presentation (n = 158, 48.3%), with 65 (19.9%) receiving initial inappropriate antibiotics and 102 (31.2%) retreated. Persistent lymphadenopathy was infrequent (n = 22, 6.7%), with 10 undergoing surgical interventions. In multivariable analysis of variables associated with retreatment, we highlight differences in time until receiving appropriate antibiotics (8 [IQR, 3.25-20.75] vs 7 [IQR, 4-11.25] days; adjusted P = .076), and doxycycline-based treatment regimen (vs ciprofloxacin; adjusted P = .084), although this was not significant after correction for multiple comparisons.
conclusionsWe comprehensively summarize clinical, laboratory, and treatment outcomes of type B tularemia. Targeting tularemia requires clinical awareness, early diagnosis, and timely commencement of treatment for an appropriate duration.
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